This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Acquired subglottic stenosis of the newborn is often associated with prolonged endotracheal intubation, and is the major cause of extubation failure and main indication of neonatal tracheostomy or airway reconstruction. Unfortunately, subglottic stenosis condition is generally diagnosed during surgical endoscopy well after airway injury has occurred. Other imaging modalities such as MRI, CT and ultrasound do not possess the necessary level of resolution to differentiate scar from edema;the major determinant of clinical prognosis and therapy. In this proposal, we propose to determine whether OCT can be used to image the subglottis in neonatal ICU patients, and identify the presence of scar or edema. Our preliminary results have shown that OCT clearly identifies in vivo tissue layers and regional architecture of the subglottis while offering detailed information concerning tissue microstructures. The diagnostic potential of this technology makes OCT a promising modality in the study and surveillance of the neonatal airway. The aims of this study are to apply OCT technology in the characterization tissue architecture, review imaging in intubated and non-intubated states, and define the feasibility of using OCT in neonates. 1. Determine the normative anatomy of the neonatal airway 2. Serially exam intubated patients over time in order to understand the evolution of subglottic changes during prolonged intubation